Uganda’s LGBTQ+ community is facing an unprecedented dual crisis: escalating criminalisation and a dangerous collapse in HIV services due to global funding cuts. A recent UNAIDS report warns that key populations—gay men, transgender people, sex workers, and people who inject drugs, are at greater risk than ever, as legal repression and reduced donour funding undermine decades of progress in the fight against HIV.

The report, released in July 2025, highlights that criminalisation of LGBTQ+ people has reached “record levels globally,” with Uganda among the most severe offenders. The Anti-Homosexuality Act, 2023, one of the harshest anti-LGBTQ+ laws in the world, includes provisions for life imprisonment and the death penalty under the guise of punishing “aggravated homosexuality.” It also criminalises any “promotion” of LGBTQ+ identities, effectively silencing health education, advocacy, and peer support.

At the same time, U.S. foreign aid, historically the backbone of Uganda’s HIV response, is under threat. According to UNAIDS, Uganda depends on international aid for more than 70% of its HIV funding. The rollback of U.S. support, particularly under renewed Republican leadership in Washington, has seen programs slashed or halted, leaving community-based clinics shuttered and frontline health workers scrambling to fill the void.

A Perfect Storm

The convergence of funding withdrawals and legal repression has created what UNAIDS describes as a “perfect storm.” In Uganda, where LGBTQ+ people are driven underground, access to HIV testing, PrEP (pre-exposure prophylaxis), condoms, and anti-retroviral treatment is now heavily compromised.

Across the country, grassroots networks are trying to bridge the gap. In informal and often secretive settings, queer health workers like Lamwaka distribute medication and offer counselling. But these underground efforts lack sustainable support and operate under constant threat of arrest.

A report by El País documented the story of Gloria, a bisexual sex worker in northern Uganda who lost access to PrEP and STI testing after the closure of a USAID-supported clinic. Too afraid to go to a public facility, she now relies on informal aid to protect herself—a dangerous and precarious existence.

The Human Cost

The consequences of this crisis are already visible. UNAIDS projections warn that without immediate intervention, an additional 6 million new HIV infections and 4 million AIDS-related deaths could occur globally by 2029. Sub-Saharan Africa, where LGBTQ+ people face both legal and social barriers, is at the epicenter of the threat.

The data is sobering: among gay men in the region, only 19% of those living with HIV are aware of their status, compared to 61% among all adult men. Criminalisation directly hinders testing and treatment, as fear of persecution keeps many away from health facilities.

Global Responsibility, Local Urgency

Activists argue that the current crisis is not only the result of domestic policy but of shifting international priorities. The United States, under previous administrations, had played a key role in funding programs specifically tailored to key populations. These included safe spaces for queer Ugandans, legal aid initiatives, and community-led outreach services. Many of these have been defunded or deemed too “controversial” under new U.S. leadership.

UNAIDS Executive Director Winnie Byanyima has called for increased domestic investment, urging African governments, including Uganda’s, to take ownership of their HIV response. However, many worry that in Uganda’s current political climate, local investment will exclude or actively marginalise LGBTQ+ people.

What Needs to Change

Experts and activists are calling for urgent action:

• Restore targeted international fundingfor community-led health programs that serve key populations.
• Repeal Uganda’s Anti-Homosexuality Actand other punitive laws that obstruct public health.
• Protect and empower community-led health initiativesby ensuring legal and financial support for those most at risk.
• Integrate LGBTQ+ voicesinto national health policy as partners, not pariahs.

Without these interventions, the gains made over the past two decades in HIV prevention and treatment may be reversed, not because of a lack of science, but because of politics and prejudice.

A Struggle for Survival

Despite the growing dangers, Uganda’s queer community remains defiant. In Uganda today, the fight against HIV is also a fight for human rights, dignity, and survival. The stakes have never been higher.